Purpose: This study examined the definitions, diagnostic criteria, and measurements of sarcopenic obesity and identified effective exercise interventions that improve cardiometabolic outcomes in middle-aged and older adults, in whom the prevalence of sarcopenic obesity is increasing. Methods: This comprehensive review followed the principles of literature search, data extraction, and review, as described in the PRISMA 2009 guidelines. Results: The 11 articles included in this study presented different concepts of sarcopenic obesity. Exercise interventions for sarcopenic obesity varied in their effects. Resistance exercise improved muscle mass and physical function, while aerobic exercise primarily impacted obesity and cardiometabolic indicators. Combined exercise had mixed results across indicators. Conclusion: This study addressed a pressing public health concern in the context of an aging population, acknowledged the unique challenges of sarcopenic obesity, and attempted to clarify definitions and assessment methods, while identifying effective exercise interventions to reduce cardiometabolic risk. Sarcopenic obesity is a multifaceted condition with varying definitions and diagnostic criteria. Its association with cardiometabolic risk underscores the need for comprehensive assessments considering both muscle and obesity indicators. While exercise interventions hold promise for managing sarcopenic obesity, further research is required to establish effective strategies.
Purpose: This study was done to suggest directions for developing exercise interventions for fall prevention in the elderly in Korea in the future, Method: Twenty five articles for fall prevention exercises were reviewed and analyzed. Result: $84.0\%$ of subjects were older adults age 65 and older living in the community. The most frequently performed interventions were lower limb strength and balance exercises together $43.3\%$, group exercise $70.0\%$, exercise 3 times/week $60.0\%$, 60 min per session $36.7\%$, duration of 12 weeks and 1 year $23.3\%$ each. The most frequently used outcome variables were static balance $84.0\%$, lower limb muscle strength $72.0\%$, dynamic balance $56.0\%$, and falls $56.0\%$. The effect of exercise interventions on fall prevention was inconclusive. Lower limb strength exercises with resistance were effective for increasing muscle strength. Balance exercises with various movements for balance were effective for increasing balance. Conclusion: Exercise interventions for fall prevention is recommended for older adults with risk factors of falling. The desirable type of exercise intervention is lower limb strength and balance exercise together.
PURPOSE: Balance exercise as well as lower extremity strengthening exercise (LESE) is known to be effective in patients with knee osteoarthritis (KOA). The purpose of this study was to investigate the effectiveness of performing LESE in conjunction with balance exercise on lower extremity function, range of motion, muscle strength, and balance in patients with KOA. METHODS: The subjects of this study were 25 patients with KOA who were recruited and randomly divided into two groups: 1) those who performed LESE with balance exercise; and 2) those who performed only LESE. Both the groups also received general physical therapy and performed aerobic exercise. The interventions were performed 3 times a week for 4 weeks. To determine the effectiveness of the interventions, we measured Western Ontario and MacMaster Universities Arthritis Index (WOMAC) score, numerical rating scale (NRS) score, passive range of motion (PROM), chair stand test (CST), and Berg Balance Scale (BBS) score at the initiation of the interventions and again after 4 weeks, at the time of completion of the interventions. RESULTS: After 4 weeks of the interventions, both the groups showed significantly improved WOMAC (p<.01), NRS (p<.01), PROM (p<.05), CST (p<.05), and BBS (p<.01) scores. However, there was no significant difference between the groups in terms of the clinical outcomes observed. CONCLUSION: These results suggest that the addition of balance exercise to a LESE regimen in patients with KOA did not provide any additional benefit.
Forward head posture (FHP) is a musculoskeletal disorder that causes neck pain. Several exercise interventions have been used in South Korea to improve craniovertebral angle (CVA) and relieve neck pain. There has been no domestic literature review study over the past 5 years that has investigated trends and effects of exercise intervention methods for CVA with neck pain. This domestic literature review aimed to evaluate the trends and effects of exercise interventions on CVA and neck pain in persons with FHP. A review of domestic literature published in Korean or English language between 2018 and 2022 was performed. Literature search was conducted on Google Scholar and Korea Citation Index by using the following keywords: "exercise," "exercise therapy," "exercise program," "forward head posture," and "neck pain." Ten studies were included in this review. All of the studies showed positive improvements after intervention programs that included exercises. Notably, four of these studies demonstrated significant differences in results between the experimental and control groups. Among the 10 studies, nine measured visual analogue scale or numerical rating scale scores and reported significant reductions in pain following interventions, including exercise programs. Five of these studies showed significant differences in results between the experimental and control groups. Furthermore, six studies that used neck disability index exhibited a significant decrease in symptoms after implementing intervention programs that included exercise, and significant differences in results were found between the experimental and control groups. This domestic literature review provides consistent evidence to support the application of various exercise intervention programs to improve CVA and relieve neck pain from FHP. Further studies are warranted to review the effects of various exercise interventions on FHP reported not only in domestic but also in international literature.
Purpose: This study aimed to examine the immediate effects of different breathing training techniques on diaphragm excursion and vital capacity in healthy adults. Specifically, the study focused on comparing respiratory exercise without PNF, bilateral pattern respiratory exercise, and bilateral pattern with spiral pattern respiratory exercise. Methods: Twenty-seven healthy adults in their 20s participated in the study. Diaphragm excursion and vital capacity were evaluated under three different conditions. A one-way repeated ANOVA was used to analyze the differences in diaphragm excursion and vital capacity among the interventions. Results: Statistically significant differences were observed in diaphragm excursion among the interventions, comparing respiratory exercise without PNF, bilateral pattern respiratory exercise, and bilateral pattern with spiral pattern respiratory exercise. Similarly, statistically significant differences were found in vital capacity among the interventions without PNF respiratory exercise, bilateral pattern respiratory exercise, and bilateral pattern with spiral pattern respiratory exercise. Conclusion: The study demonstrated that incorporating the spiral technique in respiratory exercise led to increased diaphragm excursion and lung capacity compared to other interventions. These findings suggest that PNF respiratory exercise combined with the spiral pattern may have clinical implications for the treatment of respiratory diseases. Further research is warranted to explore the long-term effects and clinical application of these approaches.
Breast cancer is the most frequently diagnosed cancer primarily affecting women and negatively impacting the individuals, families, and the health care system. Despite the well-known benefits of exercise for breast cancer survivors, rate of physical activity declines during adjuvant therapy and may not return to pre-diagnosis levels. In addition, low levels of adherence to exercise have been observed in this cohort. The challenge is to identify strategies that are effective in promoting exercise adherence. Several of the studies use social cognitive theory as a theoretical framework to design exercise interventions that encourage adherence. Within and without this framework, they have implemented interventions within the home and gym-based environments. Strategies used to encourage adherence to exercise programs and which are readily implemented in most situations have included distribution of print materials and pedometers, as well as recommendation from the oncologist. Other strategies that may be less feasible have included provision of trainers, gym memberships, regular phone-calls, and psychologist-lead stress management sessions.
The maintenance of skeletal muscle mass is very important for the prevention of life style-related diseases and the improvement of quality of life. It is well-known that resistance exercise and nutrition (especially amino acids) are the most effective interventions for maintaining skeletal muscle mass. It has been reported that many molecules are involved in the regulation of protein synthesis in response to resistance exercise and nutrition. Understanding the molecular mechanisms regulating muscle protein synthesis is crucial for the development of appropriate interventions. The role of intracellular signaling pathways through the mammalian target of rapamycin (mTOR), a serine/threonine protein kinase in the regulation of muscle protein synthesis, has been extensively investigated for these years. Control of protein synthesis by mTOR is mediated through phosphorylation of downstream targets that modulate translation initiation and elongation step. In contrast, upstream mediators regulating mTOR and protein synthesis in response to resistance exercise and amino acid still needed to be determined. In this brief review, we discuss the current progress of intracellular mechanisms for exercise- and amino acid-induced activation of mTOR pathways and protein synthesis in skeletal muscle.
Purpose: This study examined the effects of horse riding simulator exercise on the thickness changes in the transverse abdominis in normal adults. Methods: Forty-five healthy adults were recruited and randomized to a horseback riding simulation exercise group (n=15), a sling exercise group (n=15), and a trunk stabilization exercise group (n=15). A horseback riding simulator offers the indoor experience of horseback riding and mimics the rhythmic movement of horseback riding, thereby provided a virtual environment, such as riding a real horse on the front screen. The velocity of the horse riding simulator exercise was regulated within the subject's ability to control the exercise on the horse riding simulator. A sling exercise group performed sling exercise under the inspection of the experimenter. In the trunk stabilization exercise group, the subjects were instructed to perform the exercise accurately and pause the session when pain occurred during the intervention. The subjects in each group carried out the interventions three times per week for six weeks. The thickness of the transverse abdominis was measured using a pressure biofeedback unit and the ultrasound. Results: Significant differences in the thickness of transverse abdominis within the groups were observed between before and after the interventions. On the other hand, there were no differences in the parameters among the groups. Conclusion: Horse riding simulator exercise can be an alternative to trunk stabilization exercise by increasing the thickness of the transverse abdominis in healthy adults.
Purpose : This study was conducted to compare two non-face-to-face exercise interventions depending on whether mobile applications and wearable exercise aids are used to find out which interventions are more effective in improving senile sarcopenia. Ultimately, it was conducted to provide basic data for developing non-face-to-face intervention methods to improve sarcopenia. Method : In this study, 18 elderly sarcopenia and possible sarcopenia aged 65 or older were randomly assigned to the digital and self-exercise intervention groups. The digital exercise intervention group performed eight exercise programs with mobile applications and wearable exercise aids to record and manage the elderly performing the programs in real time. And the self-exercise intervention group performed the same program on its own as implemented in the digital exercise group. The intervention was applied for 8 weeks, and before and after the intervention, sarcopenia evaluation and physical function evaluation were performed. Results : In the digital exercise intervention group, arm muscle mass, skeletal muscle index, SPPB, 5TSTS, and BBS were improved, and in the self-exercise intervention group, grip strength, SPPB, 5TSTS, and BBS were improved. Conclusion : It was confirmed that both groups are effective in improving physical performance and physical function, the digital exercise intervention is effective in improving muscle mass and self-exercise intervention is effective in improving muscle strength. Therefore, this study proposes to apply intervention methods separately according to the indicators to improve and prevent sarcopenia, and also simplify the instructions of applications used to improve sarcopenia and to create an environment where users can be trained regularly on how to use it. And, In the future, studies for the development of devices to be designed to help non-face-to-face exercise interventions or studies on the differences between face-to-face and non-face-to-face exercise interventions should be conducted in terms of the effect of improving sarcopenia.
Purpose: Nonalcoholic fatty liver disease (NAFLD) is the most frequent cause of chronic liver diseases in both adults and children with obesity. The aim of this study was to compare the changes in liver enzymes and metabolic profile in adolescents with fatty liver following selected school-based exercise (SBE) and high-intensity interval training (HIIT) interventions. Methods: In a semi-experimental study, 34 obese male adolescents with clinically defined NAFLD were divided into the HIIT (n=11, age=12.81±1.02 years, body mass index [BMI]=26.68±2.32 kg/㎡), selected SBE (n=11, age=13.39±0.95 years, BMI=26.47±1.74 kg/㎡), and control (n=12, age=13.14±1.49 years, BMI=26.45±2.21 kg/㎡) groups. The ultrasonography NAFLD grade, peak oxygen uptake (VO2peak), lipid profile, insulin resistance, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels of the participants were measured before and after the exercise interventions. Results: The BMI, waist-to-hip ratio, and body fat percentage of the participants decreased, and a significant increase in VO2peak was observed after the intervention; however, the HIIT group showed a significant improvement compared with the SBE group (p<0.01). Significant reductions were observed in the levels of insulin resistance, triglyceride, total cholesterol, ALT, and AST in both groups, although high-density lipoprotein levels decreased only in the HIIT group (p<0.01). Further, a significant reduction in low-density lipoprotein level was observed in the training groups (p<0.01), but this decrease was not significant compared with the control group (p>0.01). Conclusion: HIIT and SBE are equally effective in improving health parameters in obese children and adolescents.
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